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• BACKWATER PREVENTION DEVICE PROGRAM <br /> iv Our records indicate that a backwater prevention device must be installed on your <br /> sewer connection to comply with the new ordinance. Please help us verify that our <br /> information is correct by answering the following questions about your property: <br /> Do you have a basement? Yes �o ❑ <br /> If yes,does it have plumbing fixtures(sink,toilet,floor drain et,..)? Yes No ❑ <br /> Do you have a backwater valve on your sewer line? Yeso ❑ Don't Know ❑ <br /> Do you have a grinder pump in your basement? Yes ❑ No [ 4::lon't Know ❑ <br /> Name: <br /> 7141.416i41 a... <br /> Property address:-=.t 6 2- e--,J <br /> Phone 1 < i°ticg � (741- 7 a? Phone 2: <br /> Email: <br />